<!DOCTYPE html>
<html class="x-admin-sm">

<head>
    <meta charset="UTF-8">
    <title>添加管理员</title>
    <meta name="renderer" content="webkit">
    <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1">
    <meta name="viewport" content="width=device-width,user-scalable=yes, minimum-scale=0.4, initial-scale=0.8,target-densitydpi=low-dpi" />
    <link href="/layui/css/font.css" rel="stylesheet">
    <link href="/layui/css/index.css" rel="stylesheet">
    <script charset="utf-8" src="/layui/lib/layui/layui.js"></script>
    <script src="/layui/js/index.js" type="text/javascript"></script>
    <!-- 让IE8/9支持媒体查询，从而兼容栅格 -->

</head>
<body>
<div class="layui-fluid">
    <div class="layui-row">
        <form class="layui-form">
            <div class="layui-form-item">
                <label for="patient_name" class="layui-form-label">
                    <span class="x-red">*</span>患者姓名
                </label>
                <div class="layui-input-inline">
                    <input type="text" id="patient_name" name="patient_name" required="" lay-verify="required"
                           autocomplete="off" class="layui-input">
                </div>
<!--                <div class="layui-form-mid layui-word-aux">-->
<!--                    <span class="x-red">*</span>将会成为您唯一的登入名-->
<!--                </div>-->
            </div>
            <div class="layui-form-item">
                <label for="phone_number" class="layui-form-label">
                    <span class="x-red">*</span>手机号
                </label>
                <div class="layui-input-inline">
                    <input type="text" id="phone_number" name="phone_number" required="" lay-verify="phone"
                           autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-form-item">
                <label for="age" class="layui-form-label">
                    <span class="x-red">*</span>患者年龄
                </label>
                <div class="layui-input-inline">
                    <input type="number" id="age" name="age" required="" lay-verify="age"
                           autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-form-item">
                <label for="inquiry_num" class="layui-form-label">
                    <span class="x-red">*</span>问诊次数
                </label>
                <div class="layui-input-inline">
                    <input type="number" id="inquiry_num" name="inquiry_num" required="" lay-verify="inquiry_num"
                           autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-form-item">
                <label for="pay_sum" class="layui-form-label">
                    <span class="x-red">*</span>支付总额
                </label>
                <div class="layui-input-inline">
                    <input type="number" id="pay_sum" name="pay_sum" required="" lay-verify="pay_sum"
                           autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-form-item">
                <label for="submit" class="layui-form-label">
                </label>
                <button  class="layui-btn" lay-filter="add" lay-submit="">
                    增加患者信息
                </button>
            </div>
        </form>
    </div>
</div>
<script>layui.use(['form', 'layer'],
    function() {
        $ = layui.jquery;
        var form = layui.form,
            layer = layui.layer;

        //自定义验证规则
        form.verify({
            nikename: function(value) {
                if (value.length < 5) {
                    return '昵称至少得5个字符啊';
                }
            },
            pass: [/(.+){6,12}$/, '密码必须6到12位'],
            repass: function(value) {
                if ($('#L_pass').val() != $('#L_repass').val()) {
                    return '两次密码不一致';
                }
            }
        });

        //监听提交
        form.on('submit(add)',
            function(data) {
                console.log(data);
                //发异步，把数据提交给php
                layer.alert("增加成功", {
                        icon: 6
                    },
                    function() {
                        //关闭当前frame
                        xadmin.close();

                        // 可以对父窗口进行刷新
                        xadmin.father_reload();
                    });
                return false;
            });

    });</script>
<script>var _hmt = _hmt || []; (function() {
    var hm = document.createElement("script");
    hm.src = "https://hm.baidu.com/hm.js?b393d153aeb26b46e9431fabaf0f6190";
    var s = document.getElementsByTagName("script")[0];
    s.parentNode.insertBefore(hm, s);
})();</script>
</body>

</html>
